Starting from January 1, 2023, several new policies regarding health insurance (HI) will officially come into effect.
2 SIMULTANEOUS PROCESSES OF HEALTH INSURANCE ASSESSMENT TO BE IMPLEMENTED
The health insurance assessment procedure will be established according to new regulations in Decision No. 3618/QD-BHXH of Vietnam Social Insurance (SI).
Accordingly, two forms of assessment will be carried out simultaneously, including:
Active assessment: Assessment will be performed directly by the social insurance agency.
Automatic assessment: Assessment will be performed through software to evaluated information from electronic data.
In addition, the new assessment procedure will describe in detail the costs for medical examination and treatment covered by health insurance in three forms: assessment based on data; assessment based on records and documents, and direct payment assessment.
CITIZEN CAN APPLY FOR HEALTH INSURANCE CARD AT HOME THROUGH THE NATIONAL PUBLIC SERVICE PORTAL
According to Decision No. 3510/QD-BHXH of Vietnam Social Insurance, a person solely applying for health insurance (including first time application, continuing health insurance, changing insurance group from one group to a state-assisted group, or applying by household) can perform the procedure for paying and issuing health insurance card through the National Public Service Portal.
Therefore, from January 1, 2023, citizens can stay at home to apply and pay for their health insurance premiums through the National Public Service Portal instead of going directly to the social insurance agency.
However, Article 2 of Decision 3510/QD-BHXH stipulates that this feature only applies to the following:
Health insurance applicants eligible for state budget support;
People from near-poor households, poor households, households engaged in agriculture, forestry, fishery and salt production with an average standard of living;
Applicants in health insurance by household.
AMENDMENTS ON TARGETS ELIGIBLE FOR HEALTH INSURANCE BY HOUSEHOLD
Article 37 of the Residence Act 2020 has revised the term of health insurance by household in the Health Insurance Act 2008, amended and supplemented in 2014, with the following definition: “Health insurance by household (hereinafter referred to as household) consists of those who jointly register for permanent residence or jointly register for temporary residence in a lawful place of residence in accordance with the provisions of the Residence Act.”
To ensure consistency, the Government has issued Decree 104/2022/ND-CP amending regulations on target groups eligible for health insurance by household, including:
Persons named in the same household in a permanent residence application;
Persons named in the same household in a temporary residence application;
Dignitaries or monks;
People living in social welfare establishments without state budget support for health insurance payment.
RECEIVING HEALTH INSURANCE CARD ON BEHALF OF A FAMILY MEMBER WITHOUT PRESENTING A HOUSEHOLD REGISTRATION BOOK
Clause 3, Article 38 of Residence Act 2020 stipulates: The household registration book and temporary residence book can only be used until December 31, 2022. From January 1, 2023, these two types of books are no longer valid.
Accordingly, the Government has issued Decree 104/2022/ND-CP regulating procedures related to health insurance after the removal of the household registration book.
Specifically, in Section 4, as instructed in Form No. 4 issued together with Decree 146/2018/ND-CP, Decree 104 has removed the phrase “a copy of household registration book” among the documents that a person receiving results on behalf of a family member must present to prove the personal or guardian relationship with the person to which the health insurance card is granted.
Therefore, when a relative or guardian go to receive the results on behalf of a family member, they must present the appointment letter; ID card/citizen ID card; proof of familial relationship…